Exercise therapy including resistance training and movement pattern retraining in females with patellofemoral pain: a pilot randomized controlled trial evaluating kinematics, pain and function

Abstract

BACKGROUND: Patellofemoral pain (PFP) is the second most common diagnosis of the lower extremity presenting in sports and orthopaedic centers. The etiology of PFP is multifactorial and a variety of biomechanical and strength factors have been linked to PFP. Evidence-based treatments have focused on protocols designed to restore normal biomechanical and strength patterns in the population with PFP. Such an approach has been reported as successful for the short term, while long-term outcomes have remained poor. This lack of long-term efficacy indicates that the interventions being evaluated are not sufficiently addressing deficits contributing to ongoing pain. AIMS: In this context, this project will evaluate whether progressive resistance training over at least 12 weeks with appropriate progression, and combined with movement pattern retraining can (i) effectively reduce pain and improve function; and (ii) reduce hip adduction in the short (3 meses) and long-term (12 months). METHODS: Twenty-four females with PFP will undergo a baseline assessment (pain, function and hip kinematics). Then, they will be randomized in two groups: exercise group, in which they will undergo a 12-weeks progressive resistance training and movement pattern retraining protocol; and control group, in which they will receive an education leaflet about how to manage patellofemoral pain. Follow up assessment will be made immediately following; 3-months following and 12-months following the intervention. The worst pain level at the previous month will be assessed using the visual analogue scale; function will be assessed using the anterior knee pain scale and the knee outcome in osteoarthritis survey. Hip kinematics will be assessed using an experimental set up composed by 10-Vicon cameras, in which the sample will be asked to ascend a 3-step staircase and data regarding peak hip adduction and hip adduction range of motion will be collected. The kinematic variables of interest, pain and function scores will be compared among periods of time (baseline assessment, post-intervention assessment, 3-month and 12-month follow up) and between groups (exercise group and control group) using a mixed analysis of variance. (AU)